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Children with Asperger’s can be higher-functioning than those with other forms of autism, and they’re more likely to be males than females. The differences in behavior between girls and boys can make Asperger’s harder to pinpoint in girls, Bolton said.

Some Asperger’s-associated behavior in girls can go unrecognized because it’s confused with societal expectations.

It’s not unusual for girls to be quiet and reserved, Bolton said. They can keep to themselves and be thought of as just shy. “Whatever challenges are there may go unnoticed for a while,” she said, until they reach adolescence, when “we really start to see some of the difficulty in terms of their connectedness to peers.”

By middle school, girls typically become more interested in pop culture, fashion and social media, and they begin to turn toward peers for social support, Bolton said. “Girls with Asperger’s tend to be a little more socially immature. Their interests tend to stay a little bit younger. These girls are still enjoying imaginative play and don’t necessarily care as much about following trends.”

For boys with Asperger’s, behaviors that can be problematic are more obvious. Boys may be louder, quicker to show frustration and pick arguments. “Girls tend to internalize what they’re experiencing,” Bolton said. “They’re more likely to kind of hold it in.”

Bolton said she tries to help girls with Asperger’s by teaching them skills related to taking the perspective of others and preparing for what to expect in various social situations. Going over that can help them become more comfortable and confident about the experiences they face, she said.

“I might say, “Think to yourself, where am I going? To a party, to school, to Carowinds, to church? What types of people would I expect to see there? Am I going to know anyone? What do people do there? If it’s a party, there might be music. … and people playing games. If it’s church, it will be quieter, sitting orderly in pews.’ We have to kind of break things down.”

Most people take for granted all the decisions and observations required during these social interactions. But people with Asperger’s “aren’t always tuned into the world around them,” Bolton said. “They do not as intuitively develop their social understanding.”